Incident & Injury Procedures

In order to be in compliance with state and insurance regulations, the district must have the appropriate documentation on file when certain incidents or injuries occur.

All incidents and injuries that may result in a safety issue, L&I issue, or Claim for Damages for the district, students, staff, volunteers or other third parties must be reported and sent to the Central Office.

We understand that documentation is a time consuming process. Our intent has been to make this necessity as simple as possible. We appreciate your help with maintaining the district's compliance. If you have questions, please feel free to call our office.

Completion of FormsThese forms must be completed by a staff member.  Documentation helps prevent the loss of important facts relating to the incident, in case the event later evolves into something larger than first expected.  Forms may become legal documents in a court of law or may be reviewed by administration, legal counsel and possibly the public.  Injury and Incident Reports are for documenting facts only.

If the Incident Report is being completed based on a report by the public, do not assume that their version is accurate.  Use language such as "claimant alleges that the steps were uneven, resulting in her fall" rather than "claimant fell on uneven steps".  Avoid opinions or speculation such as "I think" or "I believe" statements.

Employee Injury:  The Department of Labor and Industry has strict guidelines that must be adhered to.  Please contact the Human Resources Department to address your questions regarding staff injury.

Required Form:___Injury Report Form 3420 F3

Send completed form to:___Audrey Martin at amartin@nsd.org

Student or Visitor Injury:  The district's Risk Management Department is responsible for reviewing all incidents and determining what steps (if any) need to be taken.  This process helps alert the need to implement changes, if necessary, to help prevent other injuries from occurring.

Required Form:___Injury Report Form 3420 F3

Send completed form to:___Christine Cash at ccash@nsd.org

Incident Reports:  There are mandatory incidents that require completion of the district's Incident Report Form and must be sent to the Risk, Safety and Security Department for review and record retention.  The incidents are listed on the form but are not meant to be exhaustive.  The Risk, Safety and Security Department should be contacted for guidance when other incidents occur that could potentially become a risk and/or safety issue.

Required Form:___Incident Report Form

Send completed form to:___g.incidents@nsd.org or hard copy sent to Security Department 

Tort Claim (Claim for Damages): This form is to be completed and signed by the claimant.  See (1) Tort Claim Instructions (2) Tort Claim Form (3) Release of PHI (4) Vehicle Collision documents attached below for details. 

Questions:  Christine Cash @ 425-408-7630

 


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pdf File 1_Tort_Claim_Instructions.pdf
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pdf File 2_Tort_Claim_Form_Fillable.pdf
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pdf File 3_Release_of_PHI.pdf
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pdf File 4_Vehicle_Collision_Fillable.pdf
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